Anomalies of the Bladder

Introduction

Urine is a waste product that is obtained after the filtration of body fluids and is eliminated from the body. The urine is stored in a reservoir in the body before it is eliminated. This reservoir is called the urinary bladder. The urinary bladder plays a major role in holding the urine and controlling the amount of urine elimination. Any damage to the bladder may result in infection or retention of urine in the body. These damage and defects occurring in the bladder are called bladder anomalies.

What Is a Urinary Bladder?

The urinary system comprises organs like kidneys, ureters, bladder, and urethra. The primary function of the urinary system is to filter blood and create urine which is a waste product. The urinary bladder is the temporary storehouse of urine until it gets emptied in the urethra. The bladder is made up of muscles that stretch to hold urine.

What Is the Capacity of the Urinary Bladder?

The bladder is a hollow organ that helps to store urine. The normal capacity of the adult bladder is 400 mL - 550 mL (milliliter). Filling up to 500 mL may be tolerated, but beyond this capacity, it becomes painful.

What Are Anomalies of the Bladder?

Anomalies of the bladder refer to changes that occur in the bladder which are unusual or varied from a normal bladder. These changes could be due to various reasons like infections, injury, and lifestyle, which may affect the bladder. The damage occurring in the bladder is usually reflected in the urine.

What Are the Common Symptoms of Bladder Anomalies?

The most common symptoms of bladder anomalies are mentioned below:

• Urinary infection.

• Bladder stones.

• Backflow of urine.

• Bladder tumor.

What Are the Types of Anomalies of the Bladder?

The anomalies of the bladder may be congenital (at birth) or acquired. Most anomalies are infrequent or rare and occur in both males and females. Most of the bladder anomalies are incidental findings in the evaluation of urinary tract infections. Some of the bladder anomalies are listed below:

• Bladder Diverticula - Bladder diverticula is the herniation of the bladder through the weak muscles lining the bladder wall. It can be congenital or acquired. A diverticulum is a pouch-like bulging. The acquired diverticulum is usually common in men and occurs due to a block in the bladder outlet. The diverticulum may vary in size—the stasis of the urine within the diverticulum results in stone formation.

• Bladder Agenesis - Bladder agenesis is a rare condition characterized by the complete absence or formation of the bladder.

• Duplication Anomalies of the Bladder - It is a condition in which two urinary bladders are separated by a thin wall of muscles.

• Cystitis - Cystitis is the inflammation and infection of the urinary bladder. It is a common type of urinary tract infection. Bladder infections are usually painful and may cause health problems if they spread to the kidneys. It may cause acute or chronic pain. It commonly occurs in women. Individuals with cystitis may experience symptoms like burning or stinging sensations while urinating.

• Urinary Incontinence - The muscles of the bladder play an important role in holding urine and controlling the frequency of urination. Urinary incontinence occurs in older age. There are various types of urinary incontinence which are mentioned below:

• Stress Incontinence - During stress incontinence, the bladder leaks urine when pressure is exerted on the bladder during activities like sneezing, coughing, laughing, and heavy lifting.

• Overflow Incontinence - In overflow incontinence, the bladder is not completely emptied. The individuals may experience dribbling of urine.

• Functional Incontinence - Functional incontinence is due to the physical or mental disability of a person to urinate in time which leads to urine leakage. For example, in patients with walking disabilities, the time to reach the washroom may be delayed, which causes leakage of urine.

• Urge Incontinence - Urge incontinence is due to infections, neurological disorders, and diabetes. In this condition, the individual may experience a frequent urge to urinate, especially throughout the night.

• Mixed Incontinence - Mixed incontinence refers to a combination of incontinence that occurs simultaneously and results in urine leakage.

• Overactive Bladder - The bladder muscle is called the detrusor muscle. The uncontrollable squeezing of the bladder muscles results in urine leaking out. Overactive bladder is the common cause of urinary incontinence.

• Cystocele - A cystocele occurs due to the weakening of the pelvic muscles after childbirth. These muscles impinge on the bladder to press on the vagina resulting in difficult urination.

• Hematuria - Hematuria is a condition characterized by the presence of blood in the urine. It may be harmless or harmful, depending on the cause. Infections of the bladder are harmless causes of bleeding, which can be treated with medications. On the other hand, conditions like bladder cancer can be serious and cause severe bleeding.

• Urinary Stones - Urinary stones are hard calcified masses that are formed in the kidneys. They travel down to the bladder and block the urine flow causing severe pain.

• Bladder Cancer - Bladder cancer is the presence of a tumor in the bladder. Bladder tumors are usually diagnosed at earlier stages by the presence of blood in the urine. The common cause includes cigarette smoking. Although diagnosed and treated at an early stage, bladder cancer tends to recur. Hence the condition has to be monitored carefully.

What Are the Tests to Identify Bladder Anomalies?

Bladder anomalies can be identified by various tests, which are mentioned below:

• Cystoscopy- Cystoscopy is a procedure that helps to visualize the lining of the bladder. It is a narrow tube with a light and a camera that helps to detect any bladder problems.

• Urodynamic Testing- Urodynamic testing helps to understand the functioning of the urinary bladder. The test is usually aimed at measuring the capacity of the bladder to hold and empty urine. In addition, it also measures urine flow and pressure of urine, which aids in diagnosing bladder problems.

• Urinalysis- Urinalysis is a series of tests done on the urine to analyze any kidney or bladder anomalies. It detects the content, appearance, and concentration of the urine.

How Are Bladder Anomalies Treated?

The treatment for bladder anomalies depends on the cause of the condition.

• Conditions like bladder tumors may require surgery. Also, for other conditions like urinary incontinence and cystocele, surgery may be beneficial.

• In individuals with an obstructed outflow of urine, a catheter may be required to relieve the pressure in the bladder. A catheter is a thin and flexible tube that helps to drain urine.

• Anti-spasm medications help to relax the muscles of the bladder and improve bladder overactivity.

• Kegel exercises help to tighten the pelvic muscles and improve urine incontinence. Kegel exercise is pretending to urinate and holding the urine, which improves the pelvic muscles.

Conclusion:

The anomalies of the bladder are the defects or diseases occurring in the bladder that may affect the urine output. Most bladder anomalies can be detected earlier as symptoms are evident. Some anomalies may recur even with successful treatment, which has to be frequently monitored. However, identifying the exact cause and prompt treatment may aid in the regression of the condition.